WELCOME TO CLUB MED
Flatlining hospitals are getting revived with robots, speedy service and in-room entertainment
NOBODY wants to go to the hospital — and due to growing outpatient care and better technology, there are fewer reasons to end up there. But for those unlucky enough to find themselves waiting in a bleak emergency room, there is hope. The Post talked to local nurses, doctors and other health-care professionals about how hospitals are trying to improve the patient experience by coming up with innovative solutions for everything from overcrowding and natural disasters to patient boredom and medical errors.
Goal: Prevent overcrowding
The traditional one-stop-shop approach of hospitals typically leads to overcrowding. That, in turn, can cause waiting times to rise — and patientsurvival rates to drop. One solution is to parse out services into stand-alone facilities. In 2013, the Montefiore Health System transformed a failing 150-bed hospital in The Bronx into a dedicated emergency room at its Westchester Square Campus. Patients are immediately seen by a doctor and a nurse, resulting in more effective triage, including faster ordering of lab tests and X-rays.
If the patient needs a hospital for surgery or long-term observation, a dedicated ambulance is there to ferry the patient — as was the case when a man recently came in with multiple stab wounds. The staff stabilized the patient and then sent him to the hospital. “We have a quick transfer time,” says Norman Morales, administrative nurse manager at Westchester Square.
In 2014, Montefiore then opened the Montefiore Hutchinson Campus, also in The Bronx, which includes an outpatient surgery center for less complex, same-day procedures. Moving minor surgeries — such as ACL repairs — to an outpatient facility means fewer surgical patients pass through the hospital, and resources there can go toward patients who require ample recovery time and round-the-clock guidance.
Goal: Alleviate patient boredom
Sure, patients aren’t likely to die from boredom, but hospitals are realizing that giving patients something to do can help alleviate the anxiety that might come with a hospital visit. Innovative technology, such as high-speed Internet and hotel-style entertainment systems, can help provide welcome distractions for patients.
When NYU Langone Health opens its new 830,000-square-foot Helen L. and Martin S. Kimmel Pavilion this summer, they’ll offer inpatient entertainment systems, which are controlled from the bed and have video games, movies, gourmet-food ordering options and even apps for meditation. Also, every patient will get an iPad to borrow during their stay.
About a year ago, Lenox Hill Hospital began offering iPads to its patients while they waited. Dr. Robert Glatter, an assistant professor of emergency medicine and physician at Lenox Hill’s ER, says the amenity has been successful, especially with young children. Not only are hospital waiting rooms not equipped with kid-friendly accoutrements that a pediatrician’s might have, but parents or caretakers usually need to hold onto their smartphones while they wait.
“Making the stay more palatable is something that would drive the patient back to the hospital, or to the ER, if they needed to return,” says Glatter.
Goal: Design for disasters
In 2012, when Hurricane Sandy hit New York City, NYU Langone Health — which sits precariously next to the East River — faced a nightmare scenario. Due to an unprecedented storm surge, backup generators failed and the hospital was forced to evacuate nearly 300 patients, including critically ill newborns.
Since then, NYU Langone Health has spent more than a billion dollars beefing up infrastructure — including building 3,000 feet worth of barrier systems around its 34th Street main campus that could withstand swells 7 feet higher than Sandy’s. The hospital also installed more powerful backup generators and a backup for these backups.
Because of their weight and size, most large medical centers have traditionally installed these utilities in basements, along with essential but clunky medical imaging systems such as MRI and CT scan devices. That’s no longer the case.
“We were able to get everything out the cellar [and moved to higher floors],” says Paul Schwabacher, chief of facilities management at NYU Langone. “We think it will make us resilient for big storms, for heat waves, for utility power losses and losses of a lot of different systems.”
Goal: Reduce medication errors
Data published in the BMJ suggests that medical errors are the third leading cause of death in the US. And some of the most deadly errors can occur because of wrongfully prescribed medication, according to Dr. Rosanne Leipzig, a specialist in geriatric medicine at Mount Sinai Health System. When doctors order medications in hospitals, dosing is often automated through the hospital’s electronic medical system. The problem is that older patients often need less of any given drug.
“What we found in the hospital is the default doses for a number of medications were higher than one would expect,” says Leipzig. “What we ended up doing was creating a new set of default doses for people who are 65 and above ... to decrease the chances of bad events.”
Goal: Cut down on nurse burnout
Nurses are the front line of care at just about any hospital. They help patients stay informed and comfortable, and they conduct critical work such as taking vital signs and drawing blood for tests. Physicians also rely on them as gatekeepers in busy hospitals when patients are anxious and want answers.
It is common for nurses to be stretched too thin by all of these demands, especially in cities and states that are struggling with a nurse shortage. So-called “nurse burnout” can lower quality of care, send a hospital into chaos and even increase mortality rates. One study found that each additional patient assigned to a nurse was associated with a 7 percent increase in patient death within 30 days of the patient’s hospital admission.
In addition to staffing a hospital with more nurses, many hospital administrators are turning to technology to minimize the chronic stress nurses experience on the job. Some hospitals have done this by limiting manual labor: TUG Robots can schlep essential items, such as medicines and patient specimens, and haul up to 1,000 pounds from one corner of the hospital to another. The robots can even use the elevators, allowing nurses to spend more time tending to patients.